# TAWANA SPANN PHYSICAL THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FYZICAL THERAPY AND BALANCE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053781468
- **Authorized official:** MS. TAWANA SPANN PT (PRESIDENT)
- **Authorized official phone:** (314) 363-4078

## Contact information

- **Practice address:** 950 FRANCIS PL, STE 205, SAINT LOUIS, MO 63105-2465
- **Practice address phone:** (314) 627-1777
- **Practice address fax:** (314) 627-5747
- **Mailing address:** 950 FRANCIS PL, STE 205, SAINT LOUIS, MO 63105-2465
- **Mailing address phone:** (314) 627-1777
- **Mailing address fax:** (314) 627-5747

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 112062 | MO | Yes |

## Other

- **Enumeration date:** 09/28/2015
- **Last updated:** 09/28/2015